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Q&A: Which Medicare health plan is the best?

Posted on January 9, 2012 by

Question by cookie: Which Medicare health plan is the best?
I am considering my Medicare Health options and it is very confusing. Is there a difference between the companies offering the plans or all they all the same? I’m looking at Kaiser and Blue Shield. Anyone know if there is a difference between the two plans? Do you have a recommendation?

Best answer:

Answer by Zarnev
Yes, it is very confusing! So confusing that we don’t have enough room here to explain it all to you. I’ll give you the basics.

If you are looking at Medicare Supplements – all plans are exactly the same across the country. A plan J with one company has the same coverage as plan J with another company, the only difference is premium. There are plans A through L and also a plan called “select C” but not all companies offer all plans. Plan F and J are the most commonly chosen. No Medicare Supplement has Part D prescription drug coverage, and although some Medicare Supplement companies do have Part D available as a separate stand-alone policy some do not. The amount of copays and the drug formulary (what drugs are included in the plan) will vary greatly between companies. The main advantage with a Supplement is you can go to any doctor that accepts Medicare. The main disadvantage is the premium, which, depending on your area and the plan, can be well over $ 100.

Another option is a Medicare Advantage plan (Medicare Part C). All plans must follow the template that Medicare has established but nearly all plans have additional benefits. These additional benefits are not the same between companies. The premium can vary widely as well. There are several different types of Advantage plans: HMO, PPO, POS, PFFS, MSA, SNP, and these types will operate differently and have different additional coverage. Most Medicare Advantage plans also have Part D included but the coverage will vary widely between companies. If you get a Medicare Advantage plan without drug coverage you’d need a separate stand-alone plan. Many of these plans have doctor networks, so you’ll need to verify that your doctor accepts them. The plans without doctor networks allow you to go to any doctor that accepts Medicare but the doctor must also be willing to accept that plan and they can change their mind at any time. The main advantage is the premium; many are available at a low or even a $ 0 premium.

As I said drug coverage is the biggest difference. I analyze my client’s medications and have found over $ 1000 difference in the amount you’d pay per month between companies. You should visit a local agent that works with all the major companies in your area. There is no extra charge using an agent and they can explain all of your options and answer all of your questions.

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